The effect on drink sales of removal of unhealthy drinks from display in a self-service café

Abstract

Objective: The present study assessed the impact of the retailer-led removal of unhealthy beverages from display at a self-service café within a major health service. While unhealthy beverages remained available from behind the counter upon request, this was not communicated directly to customers. Design: Drinks were categorised based on the state government nutrient profiling system, classifying drinks as 'green' (best choices), 'amber' (choose carefully) and 'red' (limit). Total drink sales (as number of items sold per week) in the café were measured for five weeks. All unhealthy 'red' beverages were removed from display (but were still available for purchase) and the sales of all beverages were measured for another six weeks. Results: We found that, in response to this strategy, the proportion of 'red' drinks sold decreased from 33 % to 10 % of total drink sales. As 'amber' and 'green' drink sales increased in response to this strategy, total retailer sales remained steady. Most consumers appeared to switch to purchasing 'amber' drinks rather than the healthiest option, 'green' drinks. Conclusions: The removal of unhealthy beverages from display can result in consumers making healthier purchases, while not significantly affecting retailers' sales. Keywords Public health policy Nutrition Community RetailCompelling evidence suggests that consumption of unhealthy drinks is associated with weight gain and increased risk of a number of adverse health outcomes (1,2) . Therefore governing bodies and health departments around the world have made a number of recommendations to decrease their consumption (3,4) . Community retail settings represent an important avenue of unhealthy drink purchase and consumption. As such, many strategies have been considered that attempt to influence consumer choices at the point of purchase, including standardised portion sizes and warning labels (5) .In Victoria, Australia, one health service is working with its food retailers to trial and implement a range of different strategies to improve the healthfulness of foods and drinks purchased throughout the service (6) . The present study assessed the impact of one of these novel strategies, removing unhealthy drinks from display in a self-service café, on total drink sales and on sales of healthy and unhealthy drinks. These drinks were kept behind the counter and were still available on request by the customer. MethodsThe present study was a non-controlled before-and-after evaluation of a natural experiment at a café located in a major Victorian hospital. This location leads to high numbers of both sales and customers, including hospital employees and hospital patients and their families. At the café, customers make their drink selection via a self-service fridge and then take their choice to the counter to pay. These self-service fridges are displayed in conjunction with food displays.

‘The university should promote health, but not enforce it’: opinions and attitudes about the regulation of sugar-sweetened beverages in a university setting

“…These approaches require lower levels of personal responsibility or ‘agency’ from individuals to change their behaviour and aim to create environments that readily enable healthier choices [ 8 ]. Examples of these approaches include: applying specific taxes or levies to SSB products [ 9 , 10 ]; removing or restricting access to SSBs in institutional settings such as schools [ 11 , 12 ]; and changing serving size and placement of SSBs in other settings such as hospitals [ 13 ].…”

Eating occasion situational factors and sugar-sweetened beverage consumption in young adults

“…A limitation of our study is the cross-sectional design which means we cannot determine cause and effect relationships between purchasing location and behaviour (that is, does location drive purchasing or does desire to consume drive choice of purchase location?). However, empirical studies have shown that SSB purchases can be influenced by store-level environmental factors such as product placement [79] and pricing [80], suggesting that these factors should be considered in further research and in public health interventions.…”

Healthiness of Food and Beverages for Sale at Two Public Hospitals in New South Wales, Australia

“…After six weeks, the intervention reduced the proportion of ‘red’ drinks sold from 33% to 10% of total drinks sold, with a concomitant significant increase in healthier ‘amber’ and ‘green’ traffic light-classified drinks. Overall sales volume was unchanged and the retailer chose to continue with the strategy after the trial period [ 39 ]. Additionally, there is evidence that consumers of hospital food and drinks outlets would prefer the provision of healthier food items, based on a survey with a focus on vending machines of people attending a hospital in regional NSW [ 40 ].…”